Laparoscopic Sacrocolpopexy with Mesh for Apical and Anterior Pelvic Organ Prolapse: A Report of 3 Cases in Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon

Introduction: Pelvic organ prolapse (POP) is a common disorder in the health care of women that negatively impact the quality of life when symptomatic. It affects about 30% to 40% of parous women and its incident increases with age. POP etiologies can be innate like connective tissues disorder or acquired like obstetrical complications. Its management can be surgical or not surgical. Laparoscopic sacrocolpopexy is the gold standard to treat POP but its practice requires lot of skills, making vaginal or laparotomic route to be preferred by many surgeons especially in low resource countries. The aim of the present study was to assess the safety and feasibility of laparoscopic sacrocolpopexy as treatment of POP in low resource countries like Cameroon. Material and Methods: We reported a series of three cases of pelvic organ prolapse managed by laparoscopy in gynecological department of Yaoundé Gyneco-Obstetric and Pediatric Hospital, between 2018 and 2023. All the following parameters were analyzed: age, parity, obstetrical history, type of pelvic organ prolapse, surgical techniques, duration of the surgery, complications, and outcomes. Results: Three patients (40 y/o, 37 y/o, and 34 y/o) presented with the following conditions, respectively: stage 1 cystocele and stage 3 hysterocele; stage 4 cystocele and stage 3 hysterocele; and stage 3 hysterocele. They underwent laparoscopic sacrocolpopexy. Two patients experienced macrosomia deliveries, prior to the unset of the prolapse, and the last had no obvious risk factor for prolapse. The average duration of the surgery was approximately 149 minutes (135 minutes, 202 minutes and 110 minutes). There were no intraoperative complications and no recurrence after a period of 2 years follow-up. One of the patients gave birth by caesarean section, 1 year after the surgical procedure. Conclusion: POP is an increasing problem in the health care of women. Laparoscopic sacrocolpopexy is an effective technique for prolapse treatment, and it is feasible, and must be implemented in low resources countries. Learning curve can be reduced by standardization of the technique.